Healthcare Provider Details

I. General information

NPI: 1689152886
Provider Name (Legal Business Name): DAO DENTAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2018
Last Update Date: 07/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2424 PROFESSIONAL DR
ROSEVILLE CA
95661-7773
US

IV. Provider business mailing address

2424 PROFESSIONAL DR
ROSEVILLE CA
95661-7773
US

V. Phone/Fax

Practice location:
  • Phone: 916-783-4888
  • Fax: 916-666-7307
Mailing address:
  • Phone: 916-783-4888
  • Fax: 916-666-7307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number55884
License Number StateCA

VIII. Authorized Official

Name: BINH DAO
Title or Position: OWNER
Credential: DDS
Phone: 916-783-4888